Healthcare Provider Details

I. General information

NPI: 1598913352
Provider Name (Legal Business Name): DARRIN PAUL FURMAN PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: DARRIN PAUL FURMAN PTA

II. Dates (important events)

Enumeration Date: 09/05/2008
Last Update Date: 09/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2141 W PROSPECT RD
ASHTABULA OH
44004-6439
US

IV. Provider business mailing address

2141 W PROSPECT RD
ASHTABULA OH
44004-6439
US

V. Phone/Fax

Practice location:
  • Phone: 440-998-7507
  • Fax: 440-998-6222
Mailing address:
  • Phone: 440-998-7507
  • Fax: 440-998-6222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberPTA.03669
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: